Herpes Simplex Treatments from U.S. Dermatology Partners

What Is Herpes Simplex?

HSV is a viral infection that may impact numerous parts of the body, but it most often affects the skin around the mouth, buttocks, and genitals. Many people are carriers of HSV without showing any symptoms, but others will experience periodic flare-ups of symptoms. HSV is easily transferred through skin-to-skin contact and by sharing items like drinking glasses, utensils, and toothbrushes, so an essential aspect of treatment planning is learning how to prevent the spread of HSV to others.

Are There Different Types of Herpes Simplex Virus?

There are two types of HSV referred to simply as HSV-1 and HSV-2. HSV-1 is the type most commonly associated with cold sores, fever blisters, and other symptoms of herpes that often impact the face and mouth. HSV-2 is the type of herpes that frequently causes outbreaks on the buttocks and genitalia. While these two types of herpes virus are most often thought of as oral or genital herpes, it’s actually possible for people to develop either HSV-1 or 2 on any part of the body. Additionally, people may have both HSV-1 and 2 at the same time.

Who Develops Herpes Simplex?

HSV is contagious and typically transmitted through direct contact with an infected person. Anyone of any age can develop HSV if they come into contact with the virus by interacting with someone who has HSV-1 or 2. While HSV is most readily transferred during a flare-up, it may infrequently be spread from asymptomatic carriers or while the infected person isn’t experiencing a flare-up. 

Even though anyone can develop HSV-1 or 2, the people who are at greater risk for each type of HSV are described below.

Individuals who are more likely to develop HSV-1 include those who:

• Share utensils, water bottles, and other eating or drink materials
• Borrow lipstick or lip balm
• Kiss someone who has a cold sore or fever blister

The percentage of individuals in a population who have antibodies to an infectious agent is called seroprevalence. The seroprevalence of HSV-1 in people aged 14-49 years in the United States is 53.9% based on data from the National Health and Nutrition Examination Survey, meaning the majority of adults have been infected with HSV-1. Only about 30% of these individuals have clinically apparent outbreaks.

Individuals who are more likely to develop HSV-2 include those who:

• Engage in sex without using a barrier method of protection, especially with multiple partners
• Are female
• Have been diagnosed with another sexually transmitted infection
• Have a weakened or compromised immune system

Additionally, pregnant women who have an HSV flare-up during childbirth may be able to spread the condition to their child.

What Are the Symptoms of Herpes Simplex?

Some people who have an HSV-1 or 2 infection may never experience symptoms. In these cases, the infection is most often diagnosed during testing for another condition.

During a flare-up, individuals can experience any combination of the following symptoms:

• Sores or blisters
• Itching or burning sensation
• Painful urination
• General pain and discomfort
• Flu-like symptoms, including fever, headaches, exhaustion, inflamed lymph nodes, and loss of appetite

What Treatments Are Available for Herpes Simplex Virus?

Treatment for HSV-1 and 2 begins with an accurate diagnosis. During a flare-up, HSV can typically be diagnosed with a physical examination performed by a medical professional. To rule out other potential sources of HSV symptoms, your physician will likely order an HSV culture to confirm the diagnosis. The test involves swabbing an affected area and submitting the swabbed sample to a laboratory for further testing. For patients whose blisters are dried up or have resolved, blood tests will offer the greatest sensitivity. These tests look for HSV-1 and 2 antibodies in the blood.

Once you are diagnosed with HSV, your dermatologist will work with you to develop a plan to address the symptoms, reduce the risk for future flare-ups, and prevent the spread of HSV. There is no cure for HSV, so treatment is geared toward managing symptoms. In many cases, HSV flare-ups will clear up on their own, but to help reduce the length or severity of an outbreak, you may be prescribed medications that can be taken orally or applied topically, including famciclovir, valacyclovir, or acyclovir. These medications also help to reduce the risk of transmitting HSV to others. During severe flare-ups, the medication may need to be administered via injection.

Can Herpes Simplex Be Prevented?

The easiest way to prevent contracting HSV is to avoid coming into contact with anyone else who has the infection. Unfortunately, it’s not always obvious that a person has HSV since so many people with this condition are asymptomatic the majority of the time.

Taking precautions can help prevent the contraction of HSV. Some steps you can take, include:

• Never share eating or drinking utensils
• Never share lipstick or lip balm
• Never kiss someone who has a cold sore or fever blister
• Use barrier protection while engaging in sexual activities
• Use a lip balm with broad spectrum UVA/UVB protection

For those who have already contracted HSV, preventing the spread of this condition to other people is an important part of their plan to manage the condition. Though HSV can be spread by asymptomatic people, it’s most important to take special precautions during active flare-ups, such as avoiding physical contact with others (including sexual contact), sharing eating utensils or cosmetics, and contact with sores.

For some people, there is only one, initial outbreak after first contracting the virus. Others will have frequent flare-ups. In most cases, flare-ups become less frequent and less severe over time as the body develops antibodies. Even for those whose condition is mostly dormant, some triggers can lead to a flare-up. To reduce the risk for an outbreak, you should learn your triggers and try to decrease exposure.

Each person will have their own set of triggers, but some of the most common include:

• Stress
• Hormonal fluctuations
• Fever
• Sickness
• Sun damage